In-toeing

Overview
In-toeing, commonly called pigeon-toed walking, is when the feet point inward during walking.
It is most common in children but may persist into adulthood.

Causes

• Hip rotation abnormalities

• Tibial torsion (shin bone twist)

• Femoral anteversion (thigh bone rotation)

• Genetics

Risk Factors

• Children’s growth stage

• Family history of in-toeing

• Improper walking posture habits

Symptoms

• Feet pointing inward when walking

• Frequent tripping or stumbling

• Awkward gait compared to peers

Complications

• Uneven stress on knees

• Pelvic imbalance

• Long-term postural problems if untreated

Diagnosis

• Clinical observation by a specialist

• Gait analysis with 3D scanning

• Physical examination of hip and leg rotation

Prevention & Home Care

• Ensure children wear proper supportive shoes

• Encourage outdoor activities and exercise

• Avoid sitting postures that increase inward rotation (e.g., W-sitting)

Management

• Gait training and physical therapy

• Custom-made orthotic insoles to improve foot alignment and walking posture

• Corrective footwear in selected cases

• Monitoring (often improves naturally with age)

When to Seek Help

• Severe in-toeing persisting beyond age 8

• Frequent falling that affects daily activities

• Walking difficulties compared to peers